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增殖性糖尿病视网膜病变行闭合式玻璃体切除术后的玻璃体积血

Vitreous hemorrhage after closed vitrectomy for proliferative diabetic retinopathy.

作者信息

Tolentino F I, Cajita V N, Gancayco T, Skates S

机构信息

Eye Research Institute of Retina Foundation, Boston, MA.

出版信息

Ophthalmology. 1989 Oct;96(10):1495-500. doi: 10.1016/s0161-6420(89)32700-x.

Abstract

The authors reviewed the medical records of 191 patients (232 eyes) who underwent closed vitrectomy for complications of diabetic retinopathy to evaluate the clinical picture of postvitrectomy hemorrhage (PVH). One hundred thirty-nine eyes (59.9%) had at least one episode of PVH (average, 1.5 per eye) that was variable in onset, not associated with a known cause in four fifths, with no noted source in two thirds, and severe in three fourths of the cases. Using logistic regression statistical analyses, the factors significantly associated with decreased incidence of PVH include older age of patient (P = 0.0004), long duration of surgery (P = 0.0002), and poor preoperative vision (P = 0.05). Of the 139 eyes with PVH, 65 (47%) had spontaneous clearing in an average of 11.3 weeks, 53 (38%) required repeat surgery, and 21 (15%) were inoperable, lost to follow-up, or refused reoperation. Postvitrectomy hemorrhage did not significantly influence the final visual outcome.

摘要

作者回顾了191例(232只眼)因糖尿病性视网膜病变并发症接受闭合式玻璃体切除术患者的病历,以评估玻璃体切除术后出血(PVH)的临床表现。139只眼(59.9%)至少发生过一次PVH(平均每只眼1.5次),其发作情况各异,五分之四的病例无已知病因,三分之二未发现出血来源,四分之三的病例出血严重。通过逻辑回归统计分析,与PVH发生率降低显著相关的因素包括患者年龄较大(P = 0.0004)、手术时间长(P = 0.0002)和术前视力差(P = 0.05)。在139只发生PVH的眼中,65只(47%)平均在11.3周内自发吸收,53只(38%)需要再次手术,21只(15%)无法手术、失访或拒绝再次手术。玻璃体切除术后出血对最终视力结果无显著影响。

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